Provider Demographics
NPI:1124580535
Name:SUGARMAN, NATHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:
Last Name:SUGARMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8595 PICARDY AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-3674
Mailing Address - Country:US
Mailing Address - Phone:225-763-4900
Mailing Address - Fax:
Practice Address - Street 1:8595 PICARDY AVE STE 100
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3674
Practice Address - Country:US
Practice Address - Phone:225-763-4900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-03
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA331648207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty